Abstract: The rate of survival for cancer continues to improve and is now 65%. It is well-documented that African Americans bear a disproportionate burden of cancer incidence and mortality in the United States, but reasons for these disparities are only partly understood. Furthermore, for those that are cured of their cancer, little is known about the burden of adverse long-term health-related sequelae of the cancer and its treatment. Despite these gaps in knowledge, African Americans remain underrepresented in clinical trials and epidemiologic studies. Adverse long-term sequelae of cancer and its treatment are well-documented amongst pediatric cancer survivors, and several large cohort studies are following such patients. However, far less is known about survivors diagnosed during their adult years. A partnership focusing on cancer survivorship between an NCI-designated Cancer Center and a Minority-Serving Institution is the ideal mechanism to begin such investigations. Therefore, we therefore propose a pilot project, to identify, establish and follow a racially diverse cohort of adult survivors of breast, colorectal, lung and prostate cancer to document the prevalence of long-term outcomes and to investigate the reasons for disparities in these outcomes by race and socioeconomic status. This study will utilize and leverage three outstanding resources collaboratively: (1) Vanderbilt-lngram Cancer Center (VICC), an NCI-designated Comprehensive Cancer Center and (2) Meharry Medical College (MMC), an historical black college or university (HBCU) serving a predominantly minority patient population, along with consultation from experts at (3) Tennessee State University (TSU), a partnering institution with a predominant minority faculty and student body, to establish a cohort of 300 adult cancer survivors, half being African American. We hypothesize that the spectrum of adverse outcomes will be broad, differ by race and socioeconomic status, and will include organ dysfunction related to treatment, cardiovascular and pulmonary co-morbidities, psychosocial impairment and reduced physical function. Furthermore, risk factors for adverse outcomes, mortality and morbidity will include later stage at cancer diagnosis, cancer therapy, medical co-morbidities, lower socioeconomic status, and decreased access to routine medical and follow-up oncology care. These factors will influence racial disparities in survivor health status and inform future interventions targeted to eliminate such disparities.